Prognostic Significance of Survivin Expression in Osteosarcoma Patients: A Meta-Analysis.
Prognostic Significance of Survivin Expression in Osteosarcoma Patients: A Meta-Analysis.
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DOI：
10.12659/msm.894448
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发表时间：
2015-09-25
期刊：
影响因子：
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通讯作者：
Chen J
中科院分区：
文献类型：
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作者：
Liu Y;Teng Z;Wang Y;Gao P;Chen J
骨肉瘤是最常见的原发性骨恶性肿瘤，预后较差。生存素已被确定为大多数癌症的独立预后因素。在本研究中，我们评估了生存素表达对骨肉瘤患者临床结果的影响。检索在线电子数据库，查找2000年至2015年间发表的相关文章。采用比值比（OR）和风险比（RR）及其95％置信区间（CI）来计算显着性。总体而言，总共选择了20项相关研究，包括1030名患者。纳入的研究中未观察到显着异质性（P>0.01，I2<50%）。 Survivin 在 68.6% 的病例中表达。我们的结果表明，survivin表达增加了5年总生存率（RR=0.48，95% CI=0.32-0.71，P=0.0002）和术后复发率（RR=1.80，95% CI=1.09-2.97，P=0.02）。它与骨肉瘤的分级（Enneking临床分期，IIb-III vs. I-IIa：OR=5.26，95% CI=3.76-7.34，P<0.00001；Price’s分级，III vs. I+II：OR=2.04，95% CI=1.16-3.61，P=0.01）、转移和软组织侵犯相关。骨肉瘤（OR=6.25，95% CI=3.74–10.45，P<0.00001；OR=6.15，95% CI=3.74–10.11，P<0.00001）。在骨肉瘤患者中未发现存活蛋白表达与性别、年龄或肿瘤大小之间存在关系。我们的研究结果表明，survivin可以作为骨肉瘤新的诊断生物标志物，并作为确定骨肉瘤病理分类的参考指标，为骨肉瘤的基因治疗提供新的靶点。
Osteosarcoma is the most common primary bone malignancy and has poor prognosis. Survivin has been identified as an independent prognostic factor for a majority of cancers. In the present study, we evaluated the effect of survivin expression on the clinical outcome of osteosarcoma patients. Online electronic databases were searched for related articles published between 2000 and 2015. Odds ratio (OR) and risk ratio (RR) with their 95% confidence intervals (CI) were employed to calculate the significance. Overall, a total of 20 relevant studies were selected, including 1030 patients. No significant heterogeneity was observed among included studies (P>0.01, I2<50%). Survivin was expressed in 68.6% of all cases. Our results show that survivin expression increased the 5-year overall survival (RR=0.48, 95% CI=0.32–0.71, P=0.0002) and rate of postoperative recurrence (RR=1.80, 95% CI=1.09–2.97, P=0.02). It was associated with the grade of osteosarcoma (Enneking clinical stage, IIb–III vs. I–IIa: OR=5.26, 95% CI=3.76–7.34, P<0.00001; Price’s grade, III vs. I+II: OR=2.04, 95% CI=1.16–3.61, P=0.01), metastasis, and soft tissue invasion of osteosarcoma (OR=6.25, 95% CI=3.74–10.45, P<0.00001; OR=6.15, 95% CI=3.74–10.11, P<0.00001). No relationship was found between survivin expression and sex, age, or tumor size in patients with osteosarcoma. Our results suggest that survivin can function as a new diagnostic biomarker for osteosarcoma and be used as a reference index to determine pathology classification of osteosarcoma, providing new targets for gene therapy of osteosarcoma.